Title 202 | Chapter 007 | Regulation 801REG
PROPOSED
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PREVIOUS VERSION
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Kentucky Board of Emergency Medical Services
(Amendment)
202 KAR 7:801.Medical directors.
Section 1.
Agency(1)
An individual desiring initial certification as an Agency Medical Director(a)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(b)
Satisfy one of the following:1.
Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);2.
Be certified in emergency medicine by the ABEM or AOBEM and successfully complete the board-approved Kentucky EMS State Medical Introductory Course; or3.
Be certified in any specialty by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) and:a.
Successfully complete the board-approved Kentucky EMS State Medical Director Full Course; andb.
Hold and maintain current provider certification in:(i)
Advanced Trauma Life Support (ATLS);(ii)
Advanced Cardiovascular Life Support (ACLS), through either American Heart Association or the American Safety and Health Institute (ASHI); and(iii)
Pediatric Advanced Life Support or Pediatric Education for Prehospital Professionals (PEPP);(c)
Submit a completed EMS Medical Director application in KEMSIS; and(d)
Pay the fee required for certification pursuant to 202 KAR 7:030.(b)
(2)
(a)
(b)
1.
2.
3.
(3)
(a)
(b)
1.
2.
3.
(2)(4)
A physician applying to become an Agency Medical Director(5)
Section 2.
Renewal of Agency Medical Director Certification and Continuing Education Requirements. An Agency Medical Director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the renewal fee pursuant to 202 KAR 7:030;(3)
Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a physician;(4)
Submits evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:(a)
A board-approved medical director update;(b)
At least eight (8) hours of providing EMS education for agencies or providers; and(c)
At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine; and(5)
If certified pursuant to subsection (1)(b)3. of this administrative regulation, submits evidence of current certification in:(a)
ATLS;(b)
ACLS, through either the AHA or the ASHI; and(c)
Pediatric ALS or PEEP.Section 3.Section 2.
Agency(1)
Establishing medical protocols and standing orders for communications and patient care personnel;(2)
Serving as a liaison with the local medical community;(3)
Interacting with regional, state, and local EMS authorities on issues relating to EMS standards, needs and requirements and the optimization of resource utilization;(4)
Maintaining continuing education appropriate for the Agency Medical Director(5)
Restricting or limiting patient care functions of staff;(6)
Establishing patient destination policies;(7)
Establishing initial qualification of personnel involved in patient care and dispatch; and(8)
Developing, implementing, and maintaining a quality improvement program for continuous system and patient care improvement;(9)
Developing, implementing, and maintaining credentialing of personnel who provide patient care; and(10)
Developing on-line medical control policies.Section 4.
Associate Medical Director Certification.(1)
An individual desiring initial certification as an Associate Medical Director shall:(a)
Be a physician that meets the requirements of section 1 of this administrative regulation or hold a current, unrestricted license to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA);(b)
Successfully complete the board-approved Kentucky EMS State Medical Director Introduction Course;(c)
Hold and maintain current provider certification in:1.
ATLS;2.
ACLS, through either AHA or the ASHI; and3.
Pediatric ALS or PEPP;(d)
Submit a completed EMS Medical Director application in KEMSIS; and(e)
Pay the fee required for certification pursuant to 202 KAR 7:030.(2)
Associate medical directors shall only function under the supervision and authority of the agency's board-certified Agency Medical Director.(3)
If approved by the Agency Medical Director, an associate medical director may serve as on-line medical control for an agency with which the associate medical director is affiliated.Section 5.
Renewal of Associate Medical Director Certification and Continuing Education Requirements. An associate medical director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the fee required for certification renewal pursuant to 202 KAR 7:030;(3)
Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA); and(4)
Submits evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:(a)
A board-approved medical director update;(b)
At least eight (8) hours of providing EMS education for agencies or providers; and(c)
At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine.Section 6.
EMS-TEI Primary Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Primary Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(2)
Satisfy one of the following:(a)
Be a board-certified EMS Medical Director;(b)
Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);(c)
Be certified in emergency medicine by the American Board of Medical Specialties (ABMS), the American Association of Physician Specialists (AAPS), the ABEM, or the AOBEM; or(d)
Be certified in any specialty by the ABMS, the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) with evidence of training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(3)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 7.
EMS-TEI Associate Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Associate Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(2)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(3)
Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 8.
EMS-TEI Assistant Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Assistant Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine as a physician in the state where the EMS-TEI program's students are participating in clinical rotations, field experience, or a capstone field internship;(2)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(3)
Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 9.
Renewal of EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, and EMS-TEI Assistant Medical Director Certifications. An EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, or EMS-TEI Assistant Medical Director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the renewal fee pursuant to 202 KAR 7:030; and(3)
Submits evidence of current, unrestricted licensure to practice medicine as a physician in Kentucky; or(4)
If certified as an EMS-TEI Assistant Medical Director pursuant to section 8 of this administrative regulation, submits evidence of current, unrestricted licensure to practice medicine in the state where the EMS-TEI program students are participating in clinical rotations, field experience, or a capstone field internship.Section 10.
Expiration of Certifications. All certifications issued pursuant to this administrative regulation shall:(1)
Be valid for a period of two (2) years upon renewal; and(2)
Expire on December 31 of the second year from its initial issuance.Section 11.
Public Notice of Negative Action. The board office shall cause to be published on the board website the name of any person certified pursuant to this administrative regulation who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had his or her certification revoked.Section 12.
Incorporation by Reference.(1)
The following material is incorporated by reference: "EMS Medical Director" application in KEMSIS, August 2025.(2)
This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.(3)
This material is also available at kemsis.ky.gov.Section 3.
JOHN R. HOLDER, Chair
APPROVED BY AGENCY: August 14, 2025
FILED WITH LRC: September 11, 2025 at 11:55 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on November 21, 2025, at 1:00 PM ET at the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five (5) workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through November 30, 2025. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: John K. Wood, counsel for the Kentucky Board of Emergency Medical Services, 163 East Main Street, Suite 200, Lexington, Kentucky 40507, Phone: (859) 225-4714, Email: administrativeregulations@wgmfirm.com.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
John K. Wood
Subject Headings:
Emergency Medical Services, Health and Medical Services, Licensing, Physicians and Practitioners
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation establishes requirements for EMS medical directors, including certification requirements.
(b) The necessity of this administrative regulation:
This administrative regulation is necessary to regulate EMS medical directors.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation conforms to the content of KRS 311A.025 by establishing requirements for EMS medical directors.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation assists and will assist in the effective administration of KRS 311A.025 by establishing requirements for EMS medical directors.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment establishes five (5) EMS medical director certifications: (1) Agency Medical Director, (2) Associate Medical Director, (3) EMS-TEI Primary Medical Director, (4) EMS-TEI Associate Medical Director, and (5) EMS-TEI Assistant Medical Director. This amendment further establishes certification expiration dates and renewal requirements, and requires the Board to publish notice of any disciplinary sanction imposed against an EMS medical director.
(b) The necessity of the amendment to this administrative regulation:
This amendment is necessary to establish certifications for EMS medical directors, which will permit the Board to better regulate EMS medical directors. For example, establishing EMS medical director certifications enables the Board to establish and clarify different roles and responsibilities, to address misconduct through the Board’s disciplinary process, and to ensure that physicians in EMS medical director roles are qualified to oversee the provision of pre-hospital care.
(c) How the amendment conforms to the content of the authorizing statutes:
This amendment conforms to the content of KRS 311A.025 by establishing certifications and requirements for EMS medical directors.
(d) How the amendment will assist in the effective administration of the statutes:
This administrative regulation assists and will assist in the effective administration of KRS 311A.025 by establishing certifications and requirements for EMS medical directors.
(3) Does this administrative regulation or amendment implement legislation from the previous five years?
No.
(4) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
All ambulance services, medical first response agencies, EMS Training and Education Institutions (EMS-TEIs), and EMS medical directors.
(5) Provide an analysis of how the entities identified in question (4) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (4) will have to take to comply with this administrative regulation or amendment:
Ambulance services, medical first response agencies, and EMS-TEIs will be required to ensure that their medical directors are appropriately certified. Current Board-approved EMS medical directors will be required to become Board-certified EMS medical directors, which may require obtaining additional credentials. Applicants will be required to complete a Board-approved medical director course. Agency Medical Directors and Associate Medical Directors will be required to complete at least 16 hours of continuing education to be eligible for certification renewal.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (4):
This amendment is not expected to result in any additional costs to the affected entities.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (4):
Ambulance services, medical first response agencies, and EMS-TEIs will benefit from having the assurance that their medical directors are qualified to oversee the provision of pre-hospital care. EMS medical directors will benefit from the clarified roles, responsibilities, and necessary qualifications for medical directors. Agency Medical Directors and Associate Medical Directors will benefit by obtaining continuing education upon certification renewal.
(6) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(b) On a continuing basis:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation or this amendment:
The Kentucky Board of Emergency Medical Services is a state agency that receives its annual budget from the state government.
(8) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase in funding will be necessary to implement this administrative regulation. No increase in fees will initially be necessary to implement this administrative regulation. However, initial certification and renewal fees may be established in 202 KAR 7:030 in the future.
(9) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation does not establish any fees or directly or indirectly increase any fees. Initial certification and renewal fees are not currently established in 202 KAR 7:030, but may be included in a future amendment to that regulation.
(10) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because this administrative regulation applies to EMS medical directors.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation establishes requirements for EMS medical directors, including certification requirements.
(2) State whether this administrative regulation is expressly authorized by an act of the General Assembly, and if so, identify the act:
This administrative regulation is expressly authorized by KRS 311A.025, which was last amended in 2022 Ky. Acts ch. 126, sec. 3.
(3)(a) Identify the promulgating agency and any other affected state units, parts, or divisions:
This administrative regulation is promulgated by Kentucky Board of Emergency Medical Services.
(b) Estimate the following for each affected state unit, part, or division identified in (3)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(4)(a) Identify affected local entities (for example: cities, counties, fire departments, school districts):
Ambulance services and medical first response agencies.
(b) Estimate the following for each affected local entity identified in (4)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(5)(a) Identify any affected regulated entities not listed in (3)(a) or (4)(a):
EMS-TEIs.
(b) Estimate the following for each regulated entity identified in (5)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(6) Provide a narrative to explain the following for each entity identified in (3)(a), (4)(a), and (5)(a)
(a) Fiscal impact of this administrative regulation:
This administrative regulation is not expected to result in any fiscal impact.
(b) Methodology and resources used to reach this conclusion:
This administrative regulation is not expected to result in any fiscal impact as there are currently no costs or fees associated with this administrative regulation.
(7) Explain, as it relates to the entities identified in (3)(a), (4)(a), and (5)(a):
(a) Whether this administrative regulation will have a "major economic impact", as defined by KRS 13A.010(14):
This administrative regulation will not have a major economic impact.
(b) The methodology and resources used to reach this conclusion:
This administrative regulation is not expected to result in any fiscal impact as there are currently no costs or fees associated with this administrative regulation.
Kentucky Board of Emergency Medical Services
(Amendment)
202 KAR 7:801.Medical directors.
Section 1.
Agency Medical Director Certification Requirements.(1)
An individual desiring initial certification as an Agency Medical Director shall:(a)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(b)
Satisfy one of the following:1.
Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);2.
Be certified in emergency medicine by the ABEM or AOBEM and successfully complete the board-approved Kentucky EMS State Medical Introductory Course; or3.
Be certified in any specialty by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) and:a.
Successfully complete the board-approved Kentucky EMS State Medical Director Full Course; andb.
Hold and maintain current provider certification in:(i)
Advanced Trauma Life Support (ATLS);(ii)
Advanced Cardiovascular Life Support (ACLS), through either American Heart Association or the American Safety and Health Institute (ASHI); and(iii)
Pediatric Advanced Life Support or Pediatric Education for Prehospital Professionals (PEPP);(c)
Submit a completed EMS Medical Director application in KEMSIS; and(d)
Pay the fee required for certification pursuant to 202 KAR 7:030.(2)
A physician applying to become an Agency Medical Director may request a waiver for up to twelve (12) months to acquire the certifications under subsection (1)(b)3.b. of this section.Section 2.
Renewal of Agency Medical Director Certification and Continuing Education Requirements. An Agency Medical Director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the renewal fee pursuant to 202 KAR 7:030;(3)
Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a physician;(4)
Submits evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:(a)
A board-approved medical director update;(b)
At least eight (8) hours of providing EMS education for agencies or providers; and(c)
At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine; and(5)
If certified pursuant to subsection (1)(b)3. of this administrative regulation, submits evidence of current certification in:(a)
ATLS;(b)
ACLS, through either the AHA or the ASHI; and(c)
Pediatric ALS or PEEP.Section 3.
Agency Medical Director Responsibilities. Agency Medical Directors shall function under terms of employment or a contractual agreement that specifically address the responsibilities of the medical director and the employer or the contractor responsibilities for the following topics:(1)
Establishing medical protocols and standing orders for communications and patient care personnel;(2)
Serving as a liaison with the local medical community;(3)
Interacting with regional, state, and local EMS authorities on issues relating to EMS standards, needs and requirements and the optimization of resource utilization;(4)
Maintaining continuing education appropriate for the Agency Medical Director, administrative staff, communication and patient care personnel;(5)
Restricting or limiting patient care functions of staff;(6)
Establishing patient destination policies;(7)
Establishing initial qualification of personnel involved in patient care and dispatch; and(8)
Developing, implementing, and maintaining a quality improvement program for continuous system and patient care improvement;(9)
Developing, implementing, and maintaining credentialing of personnel who provide patient care; and(10)
Developing on-line medical control policies.Section 4.
Associate Medical Director Certification.(1)
An individual desiring initial certification as an Associate Medical Director shall:(a)
Be a physician that meets the requirements of section 1 of this administrative regulation or hold a current, unrestricted license to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA);(b)
Successfully complete the board-approved Kentucky EMS State Medical Director Introduction Course;(c)
Hold and maintain current provider certification in:1.
ATLS;2.
ACLS, through either AHA or the ASHI; and3.
Pediatric ALS or PEPP;(d)
Submit a completed EMS Medical Director application in KEMSIS; and(e)
Pay the fee required for certification pursuant to 202 KAR 7:030.(2)
Associate medical directors shall only function under the supervision and authority of the agency's board-certified Agency Medical Director.(3)
If approved by the Agency Medical Director, an associate medical director may serve as on-line medical control for an agency with which the associate medical director is affiliated.Section 5.
Renewal of Associate Medical Director Certification and Continuing Education Requirements. An associate medical director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the fee required for certification renewal pursuant to 202 KAR 7:030;(3)
Submits evidence of current, unrestricted licensure to practice medicine in Kentucky as a nurse practitioner (NP) or physician assistant (PA); and(4)
Submits evidence of successful completion of at least sixteen (16) hours of continuing education consisting of the following:(a)
A board-approved medical director update;(b)
At least eight (8) hours of providing EMS education for agencies or providers; and(c)
At least four (4) hours of EMS continuing education or other equivalent American Medical Association Physician's Recognition Award program (AMA PRA Category 1) or Continuing Education Unit (CEU) in emergency medicine.Section 6.
EMS-TEI Primary Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Primary Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(2)
Satisfy one of the following:(a)
Be a board-certified EMS Medical Director;(b)
Be certified in Emergency Medical Services (EMS) by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM);(c)
Be certified in emergency medicine by the American Board of Medical Specialties (ABMS), the American Association of Physician Specialists (AAPS), the ABEM, or the AOBEM; or(d)
Be certified in any specialty by the ABMS, the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) with evidence of training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(3)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 7.
EMS-TEI Associate Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Associate Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine in Kentucky as a physician;(2)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(3)
Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 8.
EMS-TEI Assistant Medical Director Certification Requirements. An individual desiring initial certification as an EMS-TEI Assistant Medical Director shall:(1)
Hold a current, unrestricted license to practice medicine as a physician in the state where the EMS-TEI program's students are participating in clinical rotations, field experience, or a capstone field internship;(2)
Successfully complete the board-approved EMS-TEI State Medical Director Course;(3)
Have training or experience in the delivery of emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care;(4)
Submit a completed EMS Medical Director application in KEMSIS; and(5)
Pay the fee required for certification pursuant to 202 KAR 7:030.Section 9.
Renewal of EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, and EMS-TEI Assistant Medical Director Certifications. An EMS-TEI Primary Medical Director, EMS-TEI Associate Medical Director, or EMS-TEI Assistant Medical Director shall be eligible for certification renewal if the applicant:(1)
Submits a completed EMS Medical Director application in KEMSIS;(2)
Pays the renewal fee pursuant to 202 KAR 7:030; and(3)
Submits evidence of current, unrestricted licensure to practice medicine as a physician in Kentucky; or(4)
If certified as an EMS-TEI Assistant Medical Director pursuant to section 8 of this administrative regulation, submits evidence of current, unrestricted licensure to practice medicine in the state where the EMS-TEI program students are participating in clinical rotations, field experience, or a capstone field internship.Section 10.
Expiration of Certifications. All certifications issued pursuant to this administrative regulation shall:(1)
Be valid for a period of two (2) years upon renewal; and(2)
Expire on December 31 of the second year from its initial issuance.Section 11.
Public Notice of Negative Action. The board office shall cause to be published on the board website the name of any person certified pursuant to this administrative regulation who:(1)
Is fined;(2)
Is placed on probationary status;(3)
Is placed on restricted status;(4)
Is suspended; or(5)
Has had his or her certification revoked.Section 12.
Incorporation by Reference.(1)
The following material is incorporated by reference: "EMS Medical Director" application in KEMSIS, August 2025.(2)
This material may be inspected, obtained, or copied, subject to applicable copyright law, at the Office of the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601, by appointment, Monday through Friday, 8 a.m. to 4:30 p.m.(3)
This material is also available at kemsis.ky.gov.JOHN R. HOLDER, Chair
APPROVED BY AGENCY: August 14, 2025
FILED WITH LRC: September 11, 2025 at 11:55 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on November 21, 2025, at 1:00 PM ET at the Kentucky Board of Emergency Medical Services, 500 Mero Street, 5th Floor 5SE32, Frankfort, Kentucky 40601. Individuals interested in being heard at this hearing shall notify this agency in writing by five (5) workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through November 30, 2025. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: John K. Wood, counsel for the Kentucky Board of Emergency Medical Services, 163 East Main Street, Suite 200, Lexington, Kentucky 40507, Phone: (859) 225-4714, Email: administrativeregulations@wgmfirm.com.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
John K. Wood
Subject Headings:
Emergency Medical Services, Health and Medical Services, Licensing, Physicians and Practitioners
(1) Provide a brief summary of:
(a) What this administrative regulation does:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation establishes requirements for EMS medical directors, including certification requirements.
(b) The necessity of this administrative regulation:
This administrative regulation is necessary to regulate EMS medical directors.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation conforms to the content of KRS 311A.025 by establishing requirements for EMS medical directors.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation assists and will assist in the effective administration of KRS 311A.025 by establishing requirements for EMS medical directors.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment establishes five (5) EMS medical director certifications: (1) Agency Medical Director, (2) Associate Medical Director, (3) EMS-TEI Primary Medical Director, (4) EMS-TEI Associate Medical Director, and (5) EMS-TEI Assistant Medical Director. This amendment further establishes certification expiration dates and renewal requirements, and requires the Board to publish notice of any disciplinary sanction imposed against an EMS medical director.
(b) The necessity of the amendment to this administrative regulation:
This amendment is necessary to establish certifications for EMS medical directors, which will permit the Board to better regulate EMS medical directors. For example, establishing EMS medical director certifications enables the Board to establish and clarify different roles and responsibilities, to address misconduct through the Board’s disciplinary process, and to ensure that physicians in EMS medical director roles are qualified to oversee the provision of pre-hospital care.
(c) How the amendment conforms to the content of the authorizing statutes:
This amendment conforms to the content of KRS 311A.025 by establishing certifications and requirements for EMS medical directors.
(d) How the amendment will assist in the effective administration of the statutes:
This administrative regulation assists and will assist in the effective administration of KRS 311A.025 by establishing certifications and requirements for EMS medical directors.
(3) Does this administrative regulation or amendment implement legislation from the previous five years?
No.
(4) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
All ambulance services, medical first response agencies, EMS Training and Education Institutions (EMS-TEIs), and EMS medical directors.
(5) Provide an analysis of how the entities identified in question (4) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (4) will have to take to comply with this administrative regulation or amendment:
Ambulance services, medical first response agencies, and EMS-TEIs will be required to ensure that their medical directors are appropriately certified. Current Board-approved EMS medical directors will be required to become Board-certified EMS medical directors, which may require obtaining additional credentials. Applicants will be required to complete a Board-approved medical director course. Agency Medical Directors and Associate Medical Directors will be required to complete at least 16 hours of continuing education to be eligible for certification renewal.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (4):
This amendment is not expected to result in any additional costs to the affected entities.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (4):
Ambulance services, medical first response agencies, and EMS-TEIs will benefit from having the assurance that their medical directors are qualified to oversee the provision of pre-hospital care. EMS medical directors will benefit from the clarified roles, responsibilities, and necessary qualifications for medical directors. Agency Medical Directors and Associate Medical Directors will benefit by obtaining continuing education upon certification renewal.
(6) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(b) On a continuing basis:
Other than administrative costs, there will be no costs to the Board in implementing this administrative regulation.
(7) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation or this amendment:
The Kentucky Board of Emergency Medical Services is a state agency that receives its annual budget from the state government.
(8) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase in funding will be necessary to implement this administrative regulation. No increase in fees will initially be necessary to implement this administrative regulation. However, initial certification and renewal fees may be established in 202 KAR 7:030 in the future.
(9) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation does not establish any fees or directly or indirectly increase any fees. Initial certification and renewal fees are not currently established in 202 KAR 7:030, but may be included in a future amendment to that regulation.
(10) TIERING: Is tiering applied?
Tiering is not applied to this administrative regulation because this administrative regulation applies to EMS medical directors.
FISCAL IMPACT STATEMENT
(1) Identify each state statute, federal statute, or federal regulation that requires or authorizes the action taken by the administrative regulation:
KRS 311A.025(1) authorizes the Board to create appropriate levels of certification or licensure, which may include certification or licensure of EMS medical directors. KRS 311A.025(3) provides that the Board may authorize a physician licensed in Kentucky to serve as an EMS medical director if the physician meets the requirements specified by the Board by administrative regulation. This administrative regulation establishes requirements for EMS medical directors, including certification requirements.
(2) State whether this administrative regulation is expressly authorized by an act of the General Assembly, and if so, identify the act:
This administrative regulation is expressly authorized by KRS 311A.025, which was last amended in 2022 Ky. Acts ch. 126, sec. 3.
(3)(a) Identify the promulgating agency and any other affected state units, parts, or divisions:
This administrative regulation is promulgated by Kentucky Board of Emergency Medical Services.
(b) Estimate the following for each affected state unit, part, or division identified in (3)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(4)(a) Identify affected local entities (for example: cities, counties, fire departments, school districts):
Ambulance services and medical first response agencies.
(b) Estimate the following for each affected local entity identified in (4)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(5)(a) Identify any affected regulated entities not listed in (3)(a) or (4)(a):
EMS-TEIs.
(b) Estimate the following for each regulated entity identified in (5)(a):
1. Expenditures:
For the first year:
None
For subsequent years:
None
2. Revenues:
For the first year:
None
For subsequent years:
None
3. Cost Savings:
For the first year:
None
For subsequent years:
None
(6) Provide a narrative to explain the following for each entity identified in (3)(a), (4)(a), and (5)(a)
(a) Fiscal impact of this administrative regulation:
This administrative regulation is not expected to result in any fiscal impact.
(b) Methodology and resources used to reach this conclusion:
This administrative regulation is not expected to result in any fiscal impact as there are currently no costs or fees associated with this administrative regulation.
(7) Explain, as it relates to the entities identified in (3)(a), (4)(a), and (5)(a):
(a) Whether this administrative regulation will have a "major economic impact", as defined by KRS 13A.010(14):
This administrative regulation will not have a major economic impact.
(b) The methodology and resources used to reach this conclusion:
This administrative regulation is not expected to result in any fiscal impact as there are currently no costs or fees associated with this administrative regulation.